MRSA risk doubled by recent treatment with antibiotics
Patients who have used antibiotics in the past four months are almost twice as likely to acquire meticillin-resistant Staphylococcus aureus as those who have not been exposed to antibiotics, a study shows. The risk is almost three times greater if the antibiotics used were quinolones or glycopeptides.
Researchers carried out a systematic review of 665 studies. They performed a meta-analysis of the 76 studies that met their inclusion criteria, and included over 24,000 patients. They found that the risk of acquiring MRSA (either being colonised or infected with the bacteria) was 1.8 times higher in patients who had taken antibiotics in the previous 126 days ±184 (mean ±standard deviation) than in those who had not (95 per cent confidence interval 1.7–1.9; P<0.001).
The relative risk for quinolones was 3 (2.5–3.5), for glycopeptides 2.9 (2.4–3.5), for cephalosporins 2.2 (1.7–2.9) and for other beta-lactams 1.9 (1.7–2.2).
The researchers say that although many studies have reported an association between previous antibiotic therapy and MRSA, the size of this association has not been properly explored.
They acknowledge that significant heterogeneity was found in the studies analysed, the most relevant being the duration of antibiotic exposure before MRSA isolation (from seven to 1,080 days). However, they say that despite the limitations of the study, the data show a clear association between exposure to antibiotics and MRSA isolation.
“A controlled use of antibiotics may, thus, be one of the few modifiable factors offering potential for primary prevention of MRSA colonisation,” they conclude. The researchers add that meticulous attention to infection control practices is also important (Journal of Antimicrobial Chemotherapy 2008;61:26).
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